The necessity of simple X-ray examination: a case report of button battery migration into the nasal cavity.

BACKGROUND: Since the discovery of button battery, it has been widely applied in various electric devices. However, the button battery has a potential risk as a foreign body in the nasopharyngeal field. Thus, there is a need for early diagnosis and removal of these batteries. METHODS: We experienced a case of foreign body in the nasal cavity. A battery was lost around a 2-year-old patient. He visited a local pediatric clinic. X-ray examination of the neck, chest. and abdomen showed no sign of a foreign body. He subsequently exhibited left cheek swelling and came to our clinic. RESULTS: X-ray examination of head revealed a metallic foreign body in the left nasal cavity. The foreign body was approached using an endoscope under general anesthesia. The nasal cavity was filled with necrotic tissue. We removed the foreign body using forceps. After surgery, perforation of nasal cavity was identified. CONCLUSIONS: The button battery was a potential risk because it contained toxic substances, could release an electrical current, and exerted direct pressure on the surrounding tissues. Surgical removal of button battery is the treatment of first choice. As for late complications, saddle nose is reported. Our patient would receive nasoplastic surgery around the age of 18 years. In summary, our patient's nose was not initially examined using x-ray study. It is very important to keep in mind the possibility of a nasal foreign body, not only for ear, nose, and throat doctors but also for pediatricians.

Brain abscess secondary to the middle ear cholesteatoma: a report of two cases.

We experienced two cases of brain abscess secondary to middle ear cholesteatoma. One, a 61-year-old woman, presented with left otalgia, appetite loss and nausea. The computed tomography obtained on admission revealed a middle ear cholesteatoma. The magnetic resonance image showed the presence of a brain abscess in the cerebellum. The brain abscess was drained and the cholesteatoma was removed using the canal down procedure under general anesthesia. Part of the cholesteatoma invaded the posterior cranial fossa was could not be removed from the otological surgical field. The patient has been under observation as an outpatient for 6 months already and no abnormal signs have been detected. The other patient, a 55-year-old man, was admitted to our hospital for a detailed examination because he had right otalgia and progressive headache. The examination of spinal fluid obtained by lumbar puncture showed marked elevation of the white blood cells count. Computed tomography revealed a middle ear cholesteatoma. The magnetic resonance image obtained on admission showed an area of low-intensity encapsulated by an area of high-intensity in the right temporal lobe. The abscess was drained and the cholesteatoma was removed using the canal down procedure under general anesthesia. The patient has been under observation for 1 year already and has presented no signs of recurrence.